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Aquatic Emergencies

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					           Aquatic Emergencies




3/5/2007                         1
                Overview
• Types of Aquatic Emergencies
• Near-Drowning and Drowning Emergencies
• Causes of Drowning
• Diving Emergencies
• Safety Measures when dealing with Aquatic
  Emergencies
• Mammalian Diving Reflex
• Deep-Water Diving Emergencies
• Emergency Care for Aquatic Emergencies

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  Types of Aquatic Emergencies
• While drownings are the type of fatality
  most commonly associated with water
  emergencies, drownings are actually
  responsible for only about 1:20 water-
  related deaths

• The rest of the drownings are mostly
  caused by diving and deep-water
  exploration, boating, and water skiing
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   Near-Drowning and Drowning
          Emergencies
• Near-drownings
  and drownings do
  not always occur
  in large bodies of
  water
• An adult can
  drown in just a
  few inches of
  water, and an
  infant in even
  less!
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   Near-Drowning and Drowning
          Emergencies

• Near-drowning is defined as survival, at
  least temporarily (24 hours), from near-
  suffocation due to submersion

• Drowning is defined as death from
  suffocation due to submersion

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Near-Drownings and Drownings
        Emergencies
• Do not get tunnel vision by associating the following
  symptoms with near-drowning emergencies:

     –     Airway obstruction
     –     Cardiac arrest
     –     Shock
     –     Spinal/Head Injuries
     –     External/Internal Bleeding
     –     Hypothermia


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                 Causes of Drowning
• The major causes of drowning include the
  following:
     –     Getting exhausted in the water
     –     Losing control and getting swept into water that is too deep
     –     Losing a support (sinking boat)
     –     Getting trapped or entangled in the water
     –     Using drugs or alcohol before getting into the water
     –     Suffering from a medical emergency while in the water
     –     Using poor judgment while in the water
     –     Suffering hypothermia
     –     Suffering trauma
     –     Having a diving accident
     –     Panic
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           Diving Emergencies
• Near-drownings can be additionally
  complicated in cases where diving is
  involved


    ALWAYS ASSUME THAT A DIVER HAS
      SUSTAINED NECK AND SPINAL
              INJURIES!

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     Safety Measures When Dealing
       With Aquatic Emergencies
• As a First Responder, you must be made aware
  of the following safety measures:
     – You need to reach the patient, but you must do so with the
       utmost concern for your OWN SAFETY!
     – Many drowning victims of water-related emergencies can be
       saved by basic life support measures (suctioning airway, AR)
     – Do not let your desire to provide these simple life-saving
       measures overwhelm your judgment!
     – Remember that water can conceal many hazards:
           •   Holes
           •   Sharp drop-offs
           •   Underwater entanglements
           •   Currents
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     Safety Measures When Dealing
       With Aquatic Emergencies
• As a First Responder, NEVER go out into the water to
  attempt a rescue unless you meet all of the following
  criteria:
     –     You are a good swimmer
     –     You are especially trained in water rescue techniques
     –     You are wearing a personal floatation device
     –     You are accompanied by other rescuers


             Failure to follow these guidelines
              can result in your becoming a
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                  patient or a fatality also!                      11
     Safety Measures When Dealing
       With Aquatic Emergencies

• If the patient is responsive and close to
  shore, remember:


           REACH, THROW,
              ROW, GO
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     Safety Measures When Dealing
       With Aquatic Emergencies
• The following are steps to be taken if the
  patient is conscious and close to shore:


         If the patient is
       close to the shore
       or in a pool, hold
       out an object to
       grab and pull the
       patient from the
       water

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     Safety Measures When Dealing
       With Aquatic Emergencies
• If no object is available or time is a factor, and the patient
  is close to you, you can use yourself to grab the patient,
  by laying down flat on your stomach and extending your
  arm or leg
• Make sure that you are secure, and you will not be
  pulled in
• If the patient is too far, you must carefully throw out an
  object that will float
• Once the patient has a firm grasp on the floatation
  device, you must find a way to tow and bring the patient
  into shore

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           Mammalian Diving Reflex
• When the face of humans has been
  submerged in cold water, a reaction
  occurs in the body where the body’s
  metabolism slows down
• With this metabolism slowing down, it
  decreases the body’s oxygen consumption
  and shunts blood to the vital organs (brain,
  lungs, and heart)

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           Deep-Water Diving
             Emergencies
• A major                  Boy do I have
                            to pee…is
  complication of         anyone looking!


  deep-water diving
  emergencies is
  coma, which can
  result from an air
  embolism, or
  decompression
  sickness

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                  Deep-Water Diving
                    Emergencies
• Air Embolism
     – Is a blocking of blood vessels by an air bubble or clusters of air bubbles
     – During a dive, pressure on the diver’s body increases as they descend
     – If the diver ascends rapidly while holding their breath, the lungs and alveoli
       become damaged, resulting in air bubbles entering the bloodstream
     – Signs and Symptoms of an Air Embolism often appear within 15 minutes of a
       diver’s surfacing
     – Signs and Symptoms of an Air Embolism are as follows:
          • Shortness of breath
          • Dizziness
          • Nausea/vomiting
          • Frothy blood in the nose and mouth
          • Blurred or distorted vision
          • Personality change


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                Deep-Water Diving
                  Emergencies
• Decompression Sickness
     – Also known as “The Bends”
     – Usually occurs when a diver ascends to quickly from a deep, prolonged
       dive
     – Gases (usually Nitrogen) breathed by the diver are absorbed into the
       bloodstream
     – Signs and Symptoms of Decompression Sickness often appear within
       12-24 hours after the dive
     – Signs and Symptoms of Decompression Sickness are as follows:
         • Shortness of Breath
         • Severe deep aching pain in the muscles and joints
         • Numbness or paralysis
         • Staggering Gait
         • Hallucinations


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              Deep-Water Diving
                Emergencies
  • Treatment for Deep-Water Diving Emergencies
    is as follows:
       – Ensure EMS (911) has been notified
       – If no signs of neck/spinal injury, position the patient
         on a board on their left side with their entire body
         declined approx. 15 degrees (to force air and gas
         bubbles to stay in the abdomen)
       – High flow oxygen (will reduce size and levels of
         nitrogen in the bloodstream)
       – Treat for shock
       – Vital Signs
       – Reassurance
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     Emergency Care for Aquatic
           Emergencies
•   Ensure EMS has been notified
•   Establish ABC’s
•   Remove the patient from the water as quickly and safely as possible
•   If you suspect a spinal injury, maintain in-line stabilization and then secure
    the patient to a spine board before removing them from the water
•   If you do not suspect a spinal injury, place the patient on their left side
•   Begin CPR if needed
•   Suction as needed
•   Provide high flow oxygen
•   Watch for gastric distention
•   Treat for shock
•   Vital Signs
•   Keep patient from walking or moving around
•   Reassurance


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     Emergency Care for Aquatic
           Emergencies




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           Aquatic Emergencies
• Remember:
     – A near-drowning patient can develop
       complications that lead to death as long as 72
       hours after the incident
     – CPR on all drowning victims, with absence of
       a pulse, has to be continued until the patient
       arrives at the hospital
     – Patient is not dead unless they are warm and
       dead

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                Summary
• Types of Aquatic Emergencies
• Near-Drowning and Drowning Emergencies
• Causes of Drowning
• Diving Emergencies
• Safety Measures when dealing with Aquatic
  Emergencies
• Mammalian Diving Reflex
• Deep-Water Diving Emergencies
• Emergency Care for Aquatic Emergencies

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           ANY QUESTIONS?




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